Benign and Malignant Diseases of the Breast: Mammography

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What is a galactocele and what is this lesion generally associated with?

A milk-filled cyst with a high fat content. It is associated with lactation.


Peau d’orange describes what type of breast?

Breast where the skin is thicker than normal—described as thickened skin syndrome


Describe why a mass lesion is seen more clearly on fatty than on dense breast tissue.

Fatty tissue is seen as a dark area on the radiograph, whereas dense breast tissue, which represents fibroglandular areas, is seen as white. Lesions are also seen as white, which makes them difficult to discern in dense breast tissue.


The term reduction mammoplasty refers to what?

A technique used to reduce the overall size of the breast for cosmetic or medical reasons


The halo is significant in the analysis of a mass on the mammogram. Describe its significance.

The halo is a complete or partial radiolucent ring seen predominately around circular or oval lesions. Typically, circular or oval lesions are benign, but the content of any lesion must be assessed.


Ultrasound and MRI are especially important in diagnosing what types of implant problems?

Implant rupture or leaks


Describe and give an example of a radiolucent lesion.

If the lesion is radiolucent, the breast parenchyma is visible through the lesion. An example is a cyst.


Give three mammographic characteristics of a benign circular lesion.

Radiolucent and radiopaque, low-optical density, halo sign, capsule, spherical or oval, smooth borders


Give three causes of benign skin thickening.

Causes of benign unilateral skin thickening include infection that can result in axillary lymphatic obstruction, which blocks the lymphatic drainage from the breast. Benign conditions that can produce bilateral skin thickening include cardiac failure and chronic renal failure.


Spicules from a lesion in the breast can cause what changes if they reach the breast skin?

Dimpling or thickened skin syndrome


What is the significance of asymmetric breast tissue?

Could indicate a malignancy, especially if seen in the posterior aspect of the breast in a postmenopausal woman. The breast tissue structure should be a mirror image on both sides.


Give two mammographic characteristics of malignant spiculated lesions.

Mammographic characteristics: distinct central mass, sharp dense line radiating in all directions from the central mass, dimpling or skin thickening if the spicules reach the skin; can be associated with malignant type calcification. Ultrasound characteristics: spiculated outline, taller than wide, shadowing, ductal extension pattern, microlobulations


Describe four characteristics of benign calcification.

Smooth borders, high uniform tissue composition, evenly scattered, sharply outlined, spherical or oval, teacup calcifications on the mediolateral (ML), ring-like, eggshell-like, large bizarre size


What are the six important factors used to analyze breast calcifications?

Calcifications can be analyzed for density in terms of how radiolucent or radiopaque they are, distribution, change over time, number, morphology, and size.


What are the two main classifications of breast cancer?

Ductal carcinoma and lobular carcinoma


Reduction mammoplasty often involves:

(A) Reducing the size of individual lobules

(B) Reducing the size of the ampule

(C) Removal of glandular tissue only

(D) Removal of breast tissue and relocation of the nipple

(D) Removal of breast tissue and relocation of the nipple


A patient with peau d’orange-type breast will present with:

(A) Breast skin that is obviously thickened

(B) Malignant breast calcifications

(C) Radiopaque breast lesions

(D) Vascular calcifications

(A) Breast skin that is obviously thickened


Benign breast calcifications include all of the following except:

(A) Vascular calcifications

(B) Plasma cell mastitis

(C) Milk of calcium

(D) Casting-type calcifications

(D) Casting-type calcifications


Which of the following describes the characteristics of benign circular or oval lesions?

(1) Radiolucent

(2) Halo sign

(3) Low optical density

(A) 1 and 2 only

(B) 2 and 3 only

(C) 1 and 3 only

(D) 1, 2, and 3

(D) 1, 2, and 3


Asymmetric breast tissue—seen as an area on one mammogram that is not reproduced on the other—is referred to as:

(A) Stellate lesion

(B) Spiculated lesion

(C) Architectural distortion

(D) Malignant lesion

(C) Architectural distortion


The halo sign is often used to identify:

(A) Benign versus malignant lesions

(B) Tumors versus fibroadenoma lesions

(C) Circular and oval lesions

(D) Stellate or spiculated lesions

(C) Circular and oval lesions


Oil cysts are:

(A) Often malignant

(B) Seen on the mammogram as eggshell-like calcifications

(C) Rarely benign

(D) Often seen after pregnancy

(B) Seen on the mammogram as eggshell-like calcifications


The two most common types of breast cancer are:

(1) Lobular

(2) Ductal

(3) Metastasis

(A) 1 and 2 only

(B) 2 and 3 only

(C) 1 and 3 only

(D) 1, 2, and 3

(A) 1 and 2 only


Which of the following lesions are likely to be malignant?

(1) Spiculated

(2) Circular

(3) Multiple lobulated

(A) 1 and 2 only

(B) 2 and 3 only

(C) 1 and 3 only

(D) 1, 2, and 3

(C) 1 and 3 only


A fibroadenoma is a:

(A) Malignant lesion found only in older women

(B) Fluid-filled duct

(C) Fibrous and adenoma tissue

(D) Round, movable, but often benign lesion

(D) Round, movable, but often benign lesion